When doctors have a simulated operating room

The cause of the disease is still unknown.

First, if phenylalanine is missing from the liver, it can only combine with transaminase when phenylalanine passes through the liver.

Finally, a large amount of phenylpyruvic acid is produced.

Phenylpyruvic acid is a metabolic waste in the human body and has a toxic effect on the central nervous system.

In severe cases, it will affect intelligence and neurological development, and may even lead to intellectual disability and nervous system damage.

This is why the little girl has epilepsy.

This disease is not difficult to treat, especially if defects are found after birth. As long as the diet is controlled, brain damage will generally not occur.

But the little girl in front of me is already two years and three months old.

It stands to reason that it was discovered a little late. Normally, it should have been checked when the baby was just born.

If this defect had been discovered at birth, there would not have been epilepsy at all.

Zhang Yi explained to the family for a long time, and the family regretted it for a while.

If they had come to Union Hospital for treatment earlier, they might have discovered the problem earlier.

Until now, the child is more than two years old and has already had epilepsy.

It may be a bit difficult to restore brain function now. We can only try to preserve the remaining brain function as much as possible and make sure that epilepsy does not recur.

Then, Zhang Yi called the Pediatric Endocrinology Department upstairs.

As a result, the number of beds in Union Hospital was too tight, and even if Zhang Yi asked, they could only give them a bed five days later.

Originally, Zhang Yi wanted to have the little girl hospitalized, but now there are no beds, so he can only prescribe medicine and let them go home for treatment.

"Remember, when you go back, you should eat less eggs, milk, meat, nuts, tofu, and other foods.

Because some of the nutrients contained in them will turn into the phenylpyruvate I just mentioned.

Why does the child's urine have a smell? It is because the phenylpyruvate content is too high.

Then you can eat vegetables, fruits, or pickles, as well as cakes, and cream can only be margarine and margarine.

For water, just drink it normally, and don't drink beverages if they contain aspartame.

And this medicine, which is an auxiliary enzyme that helps the human body synthesize tyrosine.

Because your daughter's body cannot synthesize it by itself, she has to rely on medication. Go home and take the medicine on time and combine it with diet therapy, and the situation will be much better.

And the epilepsy medicine should continue to be taken for a period of time, and stop when the attack is no longer there."

Zhang Yi listed these precautions one by one for the family members to listen to.

The girl's mother's eyes were red all the time. After Zhang Yi finished speaking, she asked in shock:

"Doctor Zhang, then... then my daughter's condition cannot be cured? Is there no way to recover? Can it only be maintained by drugs?"

"Well... well, in fact, regarding phenylketonuria, a foreign research institute has discovered an enzyme from the prokaryotic organism Anabaena that can degrade phenylalanine produced in the body.

But it is only in the experimental stage, and we don't know when it will be released.

But don't give up. Medicine is so advanced now. In the past, uremia could kill people. Can't you think of a way to cure it now?

Don't be too sad, take care of it slowly. Keeping a good mood is also good for the growth of children. "

On the side, the girl's father frowned and asked:

"Then Doctor Zhang, I want to ask, what is the cause of such a rare disease? My husband and I, including my parents, are in good health, and no one in the family has ever had any serious illness. I really don't understand why my daughter has this disease. "

Zhang Yi turned his head and found a health brochure about phenylketonuria on the small bookshelf next to him and handed it to them:

"The cause of this disease is unknown, but it is currently suspected that it may be related to family incest marriage. "

"Ah? !"

"What? Incest marriage? !"

Zhang Yi's words shocked them all.

Especially the girl's parents.

"Yes, of course, it is more common among the offspring of close relatives, and there are also some for whom the cause cannot be found.

Don't think too much, take this health brochure home and read it more.

The introduction of the disease and dietary precautions are all written in detail."

"Okay...Okay, thank you, Doctor Zhang."

After recovering from the shock, the family took the child and left.

There are all kinds of things in the world.

But whether Zhang Yi is there or not is not too lazy to pay attention.

He is only responsible for seeing patients and treating them.

After getting home from get off work, Zhang Yi

I made some simple meals to reward myself.

Although work is very busy, life is still my own.

After dinner, Zhang Yi played some iron and read some books before lying on the bed and entering the simulated operating room.

There will be an abnormal pancreatic resection surgery tomorrow morning.

The boy named Liang Yu, who has hypoglycemia and convulsion symptoms caused by insulinoma, if the pancreas is not removed in time, I am afraid that he will be like the little girl with phenylketonuria this afternoon. The treatment is too late and the whole brain is irreversibly damaged.

Therefore, Zhang Yi plans to practice again in the operating room to ensure that tomorrow's operation is foolproof.

…

Early the next morning, in the operating room of Union Hospital.

"Respiratory induced anesthesia combined with general anesthesia."

"OK, pay attention to the surgical position."

"Okay, take the bladder stone position."

"BP124/80mmhg, P94 times/min, R20 times/min, T36.4℃."

The surgical site is disinfected on a large scale and the operating room towel is laid.

Zhang Yi chose the laparoscopic method for this operation.

It is less traumatic and the boy recovered quickly.

First, insert an inflation needle under the navel to inflate, and fill the entire abdominal cavity with carbon dioxide.

This way, the field of vision will be clearer when the laparoscope is inserted.

Then make the cannula hole. Generally, doctors need to make five holes to complete the operation more conveniently.

But Zhang Yi only made two.

This operation made the doctors watching the operation couldn't help but secretly marvel.

Look!

This is Zhang Yi!

Even the director of their pancreatic surgery needs five holes, but Zhang Yi only needs two holes!

Hiss...

This is the gap between Zhang Yi and them~~!

After making the holes, start inserting the laparoscope tube. The first step is to explore and explore whether there are other inflammations and adhesions around.

Then find the pancreatic head layer by layer.

The pancreas is located outside the gastroepiploic artery and connected to the gastrocolic ligament, so a hole must be cut with an ultrasonic knife before the pancreas can be seen.

Zizizizi~

A series of gentle ultrasonic knife working sounds were heard.

Zhang Yi raised the knife and soon exposed the entire pancreas.

However, at this moment, looking at the pancreas with a blurred boundary on the laparoscope display, the old pancreatic surgeons next to him frowned and asked:

"Isn't the tumor of this boy only 3 mm away from the pancreatic duct? Why does it seem to be more than that now?"